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Comprehensive sex and reproductive health education aims to promote positive attitudes toward sex and reproductive health, and empower young people to make informed decisions.
But decent sex and reproductive health education is still lacking in many parts of the world. This leaves significant gaps in young peoples’ knowledge and understanding.
We have carried out research to figure out what young people in England are missing in their sex education lessons. We reviewed the relationships and sex education (RSE) curricula across the UK.
We found that, in England, much of the focus of sex and reproductive health education is on pregnancy prevention. Much less emphasis is given to reproductive health topics such as polycystic ovary syndrome (PCOS), endometriosis, fertility and the menopause.
We also carried out a survey of 931 students aged 16-18 across England. We found students were missing key aspects of reproductive health knowledge.
Students are not being adequately informed about fertility, despite the RSE curriculum guidelines stating that students must be taught “the facts about reproductive health, including fertility, and the potential impact of lifestyle on fertility”.
Lack of knowledge
For example, despite the fact that students learn about the menstrual cycle in RSE lessons, half of them did not know when women are most fertile during the menstrual cycle.
Less than 3% of teenagers in our study told us that they had been taught about specific reproductive health conditions such as endometriosis and PCOS. Just over 10% said they had learned about menopause.
Over 70% of students recognised the decline in egg quality and quantity with age, but only about 50% understood the effects of age on sperm quality and quantity.
In our survey, we asked students what reproductive health topics they research about outside of school. Students told us that they had sought out knowledge on a variety of reproductive health topics, including PCOS, endometriosis, menopause, miscarriage and abortion – subjects that are seldom covered in detail during RSE lessons.
Many turned to social media and the internet for answers on sex and reproductive health. While these platforms offer easy access to information, they can also expose students to misinformation from non-credible sources.
In our survey, 70% of students said that they had “a little” sex education at their school. Only 30% rated their school’s sex education as good or very good. This shows a major gap in the quality of sex education most students are getting at school.
Knowledge seeking
Our study shows that students in England want to learn more about these topics in school. When we asked them what could be done to improve sex education at school, they called for a more inclusive and comprehensive curriculum that covers a wider variety of topics – including miscarriage, abortion, masturbation and how to access sexual and reproductive health services. One student said:
All we’ve done in school is go over and over having safe sex and talked about periods which whilst is important is barely scratching the surface of things people need to know about.
Students want greater focus on sex positivity because current discussions mostly highlight negative aspects of sexual activity. They believe the importance of sexual wellbeing is often ignored. They want honest, transparent, and non-judgmental education – not teaching methods driven by fear.
Based on our findings, our research team, as part of the non-profit International Reproductive Health Education Collaboration has developed evidence-based educational resources to enhance reproductive health education. These include an education resource for teachers, information leaflets and a fertility education poster.
These tools aim to help teachers, health professionals and the public access accurate and comprehensive reproductive health education.
Under the previous government, the Department of Education proposed an update to the RSE curriculum, which included the addition of topics such as “menstrual and gynaecological health, including endometriosis, PCOS, and heavy menstrual bleeding.”
The results of a consultation on this and other proposed changes are currently under analysis. But adding these topics to the curriculum would be a crucial advancement in school reproductive health education.
Reproductive health education must be given equal importance to core academic subjects, and schools need to actively engage with students, addressing their reproductive health needs and concerns. This is crucial, as school is often the only time that students receive formal education on these topics.
By providing comprehensive and accessible information at this stage, schools can equip students with the knowledge they need to make informed decisions about their reproductive health throughout their lives.
Rina Biswakarma is affiliated with the charity Fertility Network UK.
Daniel Marcu owns shares in Virilitas Labs and he is the President of the Network for Young Researchers in Andrology (non-profit).
Joyce Harper gives paid talks on reproductive health education and has written a book called Your Fertile Years.
